When you hear the word "fleet," you might think of hundreds of school buses or thousands of trucks or vans. But organizations of all sizes own vehicles that help support their business operations. Fleets can be as large as thousands of trucks or as small as one van.

Long-term care providers with between 50 and 99 employees received an unexpected reprieve yesterday, as the Obama administration announced it would give them an extra year before having to offer health insurance

The Commission on Long-Term Care has released its full report to Congress, but some commissioners broke ranks, saying the bipartisan panel did not fulfill its mandate to offer recommendations for comprehensive reform.

October has proven to be a big month for the Affordable Care Act (ACA) with the launch of the public exchanges and the political maneuverings in Washington. Although many in the healthcare industry welcomed the delay of ACA's employer mandate, it's important to understand how decisions your organization makes in 2014 will impact 2015.

We have a problem with funding and the service delivery models in aging services. Both are broken, and both need to be addressed in any real solution is to be implemented. If the service delivery system continues without fundamental change, then costs will continue to escalate unabated. All of the money ultimately comes from the same source, us.

When the Obama administration recently announced it would push back the healthcare law's employer insurance mandate for another year, many a long-term care operator rejoiced. I'm guessing there will be more postponing and tweaking.

No sane person can criticize someone who admits being confused about how medical insurance should be funded, especially for seniors. Last week, a pair of innocently juxtaposed stories highlighted the struggle extremely well.

Nursing home advocates cheered the Obama administration's recent decision to delay implementing a key part of the Affordable Care Act, and a legal expert said operators must seize this opportunity to prepare for the future.

Many long-term care providers are worried about rising health insurance costs for groups. Health insurance costs will climb 15% to 40% for groups in 2014. However, there are opportunities to manage this expected cost increase to a level that is affordable.

For most operators, owners and CFOs in long-term care facilities, control is not a word that comes to mind when insurance is the topic. But with price increases hitting commercial insurance lines, market and coverage limitations within the aging services sector, as well as reduced capacity to service this vertical, greater control is exactly what long-term care executives should demand.

When I embarked upon the working world, it was no surprise to discover that a fair amount of newspaper reporters smoked like chimneys. It was, however, a shock to later work on the grounds of a hospital campus and see laudable healthcare professionals — people who were saving lives! — light up.

I knew I was a hopelessly timid Canadian when the armed phlebotomist approached with his hands trembling and needle drawn — and I didn't think to protest. No hand raised in the international symbol of "Stop!" No screaming dash from the room. I just gritted my teeth and stoically accepted my fate.

In an effort to boost long-term care insurance policy sales, more companies have begun selling combination products that also include traditional life insurance. These hybrid policies are usually built using universal life, which has an investment component. The policies also may pay out the death benefit early to help finance care. Sales of these new policies more than doubled last year at Genworth Financial Inc. That's quite a contrast from traditional long-term care insurance policies, which have seen their sales fall by nearly a quarter in the last five years.

Now that House Democrats, the dominant party in that chamber, have issued their proposal for healthcare reform, the non-partisan Congressional Budget Office will put a price tag on it. The full House then could vote on the measure by the end of next week.

A total of 75% of healthcare providers think that a national health insurance plan would reduce the quality of care or have a neutral effect. That is according to the results of a study of 500 various healthcare providers, including nursing homes.

Sen. Herb Kohl (D-WI) has introduced legislation that would encourage the purchase of long-term care insurance. But he also emphasized during a Wednesday hearing of the Special Committee on Aging, which he chairs, that long-term care insurance still may not be for everyone and "should not be considered as a cure-all."